Ask Proactive – One of our long-term residents fell and fractured their femur requiring a hip replacement. They returned to our facility on a skilled stay. The IDT met to discuss a primary diagnosis. Therapy insists we should use Z47.1 Aftercare following joint replacement surgery, but some of the available hospital documentation uses S72.141A Displaced intertrochanteric fracture of right femur, initial encounter for closed fracture. Which is the correct code?

by | Dec 30, 2025 | Clinical, Coding, MDS, Medicare, PDPM, Reimbursement, SNF

Q: One of our long-term residents fell and fractured their femur requiring a hip replacement. They returned to our facility on a skilled stay. The IDT met to discuss a primary diagnosis. Therapy insists we should use Z47.1 Aftercare following joint replacement...

Ask Proactive – Can I code Malnutrition (Section I5600) on the MDS based on a dietary assessment that identifies the resident as at risk for malnutrition?

by | Dec 10, 2025 | Care Planning, Clinical, Coding, Dietary, Documentation, MDS, Medicaid, Medicare, Nursing, PDPM, Physicians

Q: Can I code Malnutrition (Section I5600) on the MDS based on a dietary assessment that identifies the resident as at risk for malnutrition?   A: No.  Dietitian assessments alone do not provide sufficient documentation for coding of this item on the MDS.  ...

Ask Proactive – What types of services are included in the coding of Respiratory Therapy on the MDS? Can this be done by CMTs? What must be included in the documentation to code Respiratory Therapy?

by | Dec 3, 2025 | Compliance, Documentation, MDS, Nursing, Quality

Q: What types of services are included in the coding of Respiratory Therapy on the MDS? Can this be done by CMTs? What must be included in the documentation to code Respiratory Therapy?   A: Appendix A of the RAI manual defines Respiratory Therapy as “Services...